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Finding the Right Treatment for Axial Spondyloarthritis

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Axial Spondyloarthritis: 8 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Karon Warren on May 8, 2020
  • Young professional woman at desk with lower back pain
    Axial spondyloarthritis presents early, but is treatable.
    Unlike many other forms of arthritis, axial spondyloarthritis—inflammation of the spine resulting in low back pain—commonly afflicts young adults. Left untreated, it could lead to spinal damage in the form of reduced mobility and even ankylosing spondylitis, wherein some of the bones of the spine fuse together. Although it may not be cured, if diagnosed early enough, axial spondyloarthritis can be treated with medication and proper exercise, allowing patients to enjoy a high quality of life.
  • Nurse doing physiotherapy exercises with patient.
    1. “Most of the time, symptoms start in early adulthood.”
    While arthritis often is associated with older men and women, this particular form of arthritis starts in early adulthood. “Patients with axial spondyloarthritis often are diagnosed in their teens, 20s or 30s, with men usually more symptomatic than women,” says Neal S. Birnbaum, M.D., FACP, MACR, director of the Division of Rheumatology at California Pacific Medical Center in San Francisco.
  • man in low light sitting up in bed with head in hand
    2. “Symptoms often start slowly and worsen over time.”
    According to Shailendra Singh, M.D., MBBS, FACP, rheumatology medical director at White River Medical Center in Batesville, Ark., symptoms start slowly and get worse over time. These symptoms include nighttime pain and morning stiffness that lessens throughout the day with activity. However, pain and stiffness usually return when the patient becomes sedentary for extended periods of time. “As the symptoms mostly improve with exercise, these people are late to present to a doctor,” Dr. Singh says.
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  • Senior father and son talking while having coffee on sofa
    3. “Genetic predisposition is one of the most important risk factors.”
    Although not the only risk factor, a family history certainly plays a key role in contracting axial spondyloarthritis— “70 to 90% of individuals with axial spondyloarthritis are positive for HLA B27, a genetic marker found in only 6 to 8% of the overall population,” Dr. Birnbaum says. Smoking is another major risk factor. “Smoking is the single most common and modifiable risk factor,” Dr. Singh says. “If you have a family history, then smoking can increase the risk of you having this disease.”
  • Lady having CAT scan
    4. “MRIs can be more effective than X-rays in diagnosing axial spondyloarthritis.”
    Currently, there is no blood test for axial spondyloarthritis. “Markers of inflammation may be elevated in people with inflammatory arthritis, but they are not diagnostic or prognostic,” explains Dr. Singh. While the effects of axial spondyloarthritis may not show up on X-rays for many years, an MRI could be more revealing. “In recent years, an MRI of the sacroiliac joints has become a common way to identify early abnormalities that can be seen before there are changes on plain X-rays,” Dr. Birnbaum says. “The term ‘nonradiographic axial spondyloarthritis’ is used to describe individuals with normal X-rays but abnormal MRI of the sacroiliac joints.”
  • woman in bathroom looking at eyes in mirror
    5. “Having axial spondyloarthritis can lead to eye problems.”
    For many patients living with axial spondyloarthritis, episodes of iritis—bouts of inflammation inside the eye—are quite common. “Symptoms are usually only in one eye at the time and respond quickly to steroid eye drops,” Dr. Birnbaum says. “Symptoms of iritis can include eye pain, redness, blurred vision and sensitivity to light.” If treated quickly, iritis can be cured, but, in some cases, it can lead to more serious eye problems, including glaucoma, severe vision loss and even blindness.
  • Bottle of ibuprofen pills spilling out onto white surface
    6. “Treatment often is provided through medications.”
    As an initial treatment, non-steroidal anti-inflammatory drugs, or NSAIDs, like ibuprofen and naproxen often can provide relief to low back pain resulting from axial spondyloarthritis. “For those who require additional therapy, the advent of biologic agents, particularly anti-TNF drugs, has been a tremendous advance,” Dr. Birnbaum says. “In fact, failure to respond to an anti-TNF should prompt a search to be sure the pain is not from another cause, such as degenerative disc disease or fibromyalgia rather than axial spondyloarthritis.”
  • Woman practicing cat pose in yoga on floor mat
    7. “Regular exercise also can provide relief.”
    Staying active and physically fit can be effective additions to any treatment plan for axial spondyloarthritis. “A lot of times people with axial spondyloarthritis think medication and intervention are the only things that are going to be able to help them,” says Dr. Alex Tauberg DC, CSCS, CCSP, EMR, owner of Tauberg Chiropractic & Rehabilitation in Pittsburgh. “However, there is evidence to suggest that a regular home exercise routine that focuses on mobility and stability of the spine can be beneficial for those with these inflammatory conditions. While exercise will not reverse the condition, it can help to reduce pain and improve function.”
  • Fruit snack
    8. “Dietary changes also can be beneficial in treating axial spondyloarthritis.”
    As with many other conditions, what you eat can impact how axial spondyloarthritis affects you. “As with all other autoimmune conditions, keeping body inflammation low is paramount,” says Dr. Suhyun An, D.C., MSN, NP-C, clinic director at Campbell Medical Group in Houston. “Some of the most commonly available inflammatory foods are gluten, soy, and sugar- and carb-rich foods. So being on a clean diet that avoids those foods can sometimes have marked improvement in the patient’s condition.”
Axial Spondyloarthritis: 8 Things Doctors Want You to Know
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Last Review Date: 2020 May 7
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